Organization
WICHITA DIAGNOSTIC PATHOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALE GRAHAM (ADMINISTRATOR)
(316) 962-2877
Entity
Organization
Contact information
Practice address
550 N HILLSIDE ST, WICHITA, KS 67214-4910
(316) 962-2877
Mailing address
PO BOX 865, WICHITA, KS 67201-0865
(316) 962-2877
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
—
—
Other
Enumeration date
03/07/2006
Last updated
09/11/2025
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